Facts About Social Phobia

Social phobia, also called social anxiety, is a
disorder characterized by overwhelming anxiety and excessive
self-consciousness in everyday social situations. People with social
phobia have a persistent, intense, and chronic fear of being watched and
judged by others and of being embarrassed or humiliated by their own
actions. Their fear may be so severe that it interferes with work or
school - and other ordinary activities. While many people with social
phobia recognize that their fear of being around people may be excessive
or unreasonable, they are unable to overcome it. They often worry for days
or weeks in advance of a dreaded situation.

Social phobia can be limited to only one type of
situation - such as a fear of speaking in formal or informal situations,
or eating or drinking in front of others - or, in its most severe form,
may be so broad that a person experiences symptoms almost anytime they are
around other people. Social phobia can be very debilitating - it may even
keep people from going to work or school on some days. Many people with
this illness have a hard time making and keeping friends.

Physical symptoms often accompany the intense
anxiety of social phobia and include blushing, profuse sweating,
trembling, and other symptoms of anxiety, including difficulty talking and
nausea or other stomach discomfort. These visible symptoms heighten the
fear of disapproval and the symptoms themselves can become an additional
focus of fear. Fear of symptoms can create a vicious cycle: as people with
social phobia worry about experiencing the symptoms, the greater their
chances of developing the symptoms.. Social phobia often runs in families
and may be accompanied by depression or alcohol dependence.

How Common Is Social Phobia?

About 3.7% of the U.S. population ages 18 to 54
- approximately 5.3 million Americans - has social phobia in any given
year.

Social phobia occurs in women twice as often as
in men, although a higher proportion of men seeks help for this
disorder.

The disorder typically begins in childhood or
early adolescence and rarely develops after age 25.

What Causes Social Phobia?

Research to define causes of social phobia is ongoing.

Some investigations implicate a small structure
in the brain called the amygdala in the symptoms of social phobia. The
amygdala is believed to be a central site in the brain that controls
fear responses.

Animal studies are adding to the evidence that
suggests social phobia can be inherited. In fact, researchers
supported by the National Institute of Mental Health (NIMH) recently
identified the site of a gene in mice that affects learned
fearfulness.

One line of research is investigating a
biochemical basis for the disorder. Scientists are exploring the idea
that heightened sensitivity to disapproval may be physiologically or
hormonally based.

Other researchers are investigating the
environment's influence on the development of social phobia. People
with social phobia may acquire their fear from observing the behavior
and consequences of others, a process called observational learning or
social modeling.

What Treatments Are Available for Social Phobia?

Research supported by NIMH and by industry has shown
that there are two effective forms of treatment available for social
phobia: certain medications and a specific form of short-term
psychotherapy called cognitive-behavioral therapy. Medications include
antidepressants such as selective serotonin reuptake inhibitors (SSRIs)
and monoamine oxidase inhibitors (MAOIs), as well as drugs known as
high-potency benzodiazepenes. Some people with a form of social phobia
called performance phobia have been helped by beta-blockers, which are
more commonly used to control high blood pressure.

Cognitive-behavior therapy is also very useful in
treating social phobia. The central component of this treatment is
exposure therapy, which involves helping patients gradually become more
comfortable with situations that frighten them. The exposure process often
involves three stages. The first involves introducing people to the feared
situation. The second level is to increase the risk for disapproval in
that situation so people build confidence that they can handle rejection
or criticism. The third stage involves teaching people techniques to cope
with disapproval. In this stage, people imagine their worst fear and are
encouraged to develop constructive responses to their fear and perceived
disapproval.

Cognitive-behavior therapy for social phobia also
includes anxiety management training - for example, teaching people
techniques such as deep breathing to control their levels of anxiety.
Another important aspect of treatment is called cognitive restructuring,
which involves helping individuals identify their misjudgments and develop
more realistic expectations of the likelihood of danger in social
situations.

Supportive therapy such as group therapy, or couples
or family therapy to educate significant others about the disorder, is
also helpful. Sometimes people with social phobia also benefit from social
skills training.

What Other Illnesses Co-Occur With Social Phobia?

Social phobia can cause lowered self-esteem and
depression. To try to reduce their anxiety and alleviate depression,
people with social phobia may use alcohol or other drugs, which can lead
to addiction. Some people with social phobia may also have other anxiety
disorders, such as panic disorder and obsessive-compulsive disorder.

Source: National Institute of Mental Health, National Institutes of Health